Preparing for the invasion of retail clinics: MultiCare jumps in with Rite Aid while physicians rethink business plan


Preparing for the invasion of retail clinics: MultiCare jumps in with Rite Aid while physicians rethink business plan

The Rite Aid RediClinic is a retail clinic done in partnership with MultiCare Health System. While it is based in King County, MultiCare officials expect the retail clinics to eventually trickle down to Pierce County.

By Zachariah Bryan

JULY 2015 – Close your eyes and imagine a world where you can pick up a birthday card, buy a candy bar, pick out some flowers and see your doctor.

Now, open your eyes, because that world already exists. They’re called retail clinics and they’re popping up everywhere — at RiteAid, WalMart, CVS and Walgreens. And they’re causing quite the stir in the health care community.

In Washington, most retail clinics are opening up in the Seattle market. There is  currently just one in the South Sound: the MultiCare Express Clinic at a Rite Aid in Lakewood. But that doesn’t mean people aren’t expecting them to start popping up.

Christi McCarren, MultiCare vice president of service lines, looks at it as a foregone conclusion.

“Oh yeah, I do (think retail clinics will come). I think the general public is going to demand it, for one. I guarantee you they will be down here in Tacoma, because health care has moved. It’s consumerism,” she said.

McCarren explained that the biggest driver for popularity of retail clinics is the fact that people are now more financially responsible for their own care than ever.

“It it’s true, what has been predicted is within five years, we’ll have a significant number of people on high deductible plans. We have to pay attention to pricing and location now more than ever,” she said.

In the past, physicians would expect the patients to come to them, to call them. But now, health care systems need to be more proactive about giving people a reason to come in to utilize them. The tables have turned, in a sense.

“There isn’t the same degree of loyalty as you would see with the older generation,” she said.

In May, Tacoma-based MultiCare announced a partnership with Rite Aid to open 11 RediClinics in King and Snohomish counties, including Kenmore, Mercer Island, Monroe, Mukilteo, Sammamish, Shoreline, Woodinville, Arlington, Bellevue and Mill Creek. MultiCare has agreed to open up a couple more in the Seattle market before it can start talking about the South Sound, McCarren said.

In addition, there are movements happening that would suggest more will be coming. CVS Health Corp. announced on June 15 that it would purchase Target’s pharmacies and clinics for $1.9 billion. With the deal, CVS could expand the presence of its MinuteClinics to Target’s nearly 2,000 locations nationwide.

Group Health Cooperative spokesperson Jackson Holtz said that his organization will be expanding its CareClinic through a partnership with Bartell Drugs, which has locations in South King County and Pierce County.

And while Walgreen’s Healthcare Clinic is not even on the West Coast yet, the company announced last month that it would be expanding its MDLIVE telemedicine services to Washington. In the announcement, Divisional Vice President of Digital Health Adam Pellegrini emphasized, “our society truly values anytime, anywhere convenience.”

At CHI Franciscan Health, Chief Medical Officer Mark Adams said they were already preparing for the invasion.

“I’m sure they will come,” he said. “We have been thinking about how we respond. How do we adapt to that?”

Retail clinics are one reason that CHI Franciscan has stressed the value of patient satisfaction. Adams believes that his group can compete with retail clinics by developing a bond with patients and creating what he called a “membership,” where people feel comfortable coming back to receive all of their health care needs — kind of like a health-centered YMCA.

Another weapon in Franciscan’s arsenal is Virtual Urgent Care, where patients can connect with doctors via phone or video chat for just $35 a visit.

“We’re not going to be able to replicate retail clinics. We don’t have a bunch of spaces to do that (like RiteAid or Walgreens),” Adams said. “We just need to think about how we can provide that convenience factor, but not necessarily replicate those models.”

Jennifer Hanscom, executive director and CEO of Washington State Medical Association, believes the traditional nine-to-five primary care physician will have to be a little less traditional. This could mean staying open later hours, opening on weekends and being available for same day or drop-in appointments.

“The positive is, you’re making health care readily available. That’s a good thing. I think it’s an interesting partnership,” Hanscom said. “At the same time, the force of this unexpected competition, in terms of having some of these health care services at retail clinics, is causing a lot of practices to think about how they’re restructuring their practices.”

There are concerns about retail clinics, Hanscom said, particularly when it comes to the continuum of care.

“One of the cautionary points of retail medicine is, how do you make sure the care information is getting transferred back to the patient’s physician. If I take my son to Safeway to get all his vaccinations, how will his physician know?” she asked.

Hanscom said it was important to establish a medical “home” or establish a primary care relationship. She worried that many people who go into a retail clinic to get basic services might not think about establishing a medical home, which can lead to problems down the road if a miscommunication occurs when something serious does come up.

For MultiCare, however, that isn’t much of a problem, McCarren said. Its partnership with RiteAid allows MultiCare to transfer patient information with ease, establish a continuum of care and refer patients to a clinic or hospital with more services when needed. (Running the only retail clinic in the South Sound doesn’t hurt, either.)

McCarren also questioned the notion that patients should go to one place for all of their health care needs. She said last year that capacity in the primary care offices started to become a real issue with more and more people getting on Medicaid plans in the state.

“Our offices were just bursting at the seams,” she said. “We were trying to figure out a way to offload them.”

Doctors_Guide_COVER_2015_10x17_FINAL_1As a result, MultiCare Express Clinic in Lakewood exploded in use, with a volume increase of 62 percent, the management executive said. McCarren said it seems appropriate to move low-risk conditions to retail clinics, where a nurse practitioner is more than capable of handling patients, and as a result, free up physicians to tend to more complicated issues.

“Does one provider have to provide all the care in order for us to address the contiium of care? In a perfect state, I would say yes, but we’re not in a perfect day and age. People want access and a price they can afford, when they want it. Having to wait eight weeks? That’s off-putting to a lot of people,” she said.

Adams said it will be important to view the progress and success of retail clinics through a health care perspective.

“The reason those organizations are getting into (the retail clinic) business really is to add some revenue to an existing business,” he said. “The question we will have to ask is, is this really adding value to our health system and reducing costs? Or is it adding an extra level of cost and utilization that’s not necessary? I don’t know. We’ll see.”

Adams gave the example of physicians prescribing antibiotics for ear infections, when most so-called ear infections are not actually infections, but earaches.

“When I step back and think about my role as a medical officer, that’s something we want to change. We don’t want people getting antibiotics for things they don’t need them for,” he said.

Hanscom made a similar point.

“When we think of a retail clinic, we think about really basic services. We’ll be watching that movement to see if retail medicine is looking at expanding into chronic care management,” she said.

In the meantime, those traditional mom-and-pop physicians will have to rethink their strategy.

“You have to adapt to the market,” Hanscom said. “You have to be able to think creatively about your business structure and how you can be readily available to your patients so they don’t leave for competition.”


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